Individual provider Active NPI

Stephanie Lynn Carlton, NURSE PRACTITIONER

  • Nurse Practitioner
  • Rochester, NY
National Provider Identifier
1255032504
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F351174-01 Issued in NY
Practice address
300 Meridian Centre Blvd Ste 320
Rochester, NY 14618-3984
Phone
(999) 999-9999
NPI assigned
Mar 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F351174-01 NY Primary

Addresses

Primary practice location

300 Meridian Centre Blvd Ste 320
Rochester, NY 14618-3984

Mailing address

6656 Route 5
Portland, NY 14769-9630
Phone (716) 785-1950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240515000710 NY Order and Referring Only - Nurse Practitioner 1254772718

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
F351174-01NYMDNurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1678752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1255032504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6656 ROUTE 5",
            "city": "PORTLAND",
            "state": "NY",
            "postal_code": "147699630",
            "telephone_number": "716-785-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MERIDIAN CENTRE BLVD STE 320",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146183984",
            "telephone_number": "999-999-9999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLTON",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-14",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "F351174-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.